The federal government has authorized ten plans for Medigap policies. Each is named with a letter of the alphabet. Plan A has the lowest premiums, but out-of-pocket expenses for healthcare will be highest with Plan A. More than half of Medigap policyholders in West Virginia have a Plan F policy, which provides the most comprehensive coverage. Plan C, also popular in West Virginia, provides more generous benefits than most of the other options.
Check marks in the chart denote a coverage of 100% of the described Medigap benefit. If there is no check mark and instead a percentage marker, Medigap policies on each plan cover up to that percentage for the according benefit provision. If a box is blank, the Medigap policy is not sufficient for that benefit. You should also note that Medigap plans from MedicareSupplementalInsurance.com providers only cover your coninsurance premiums if you have already paid the deductible.
Check marks in the chart denote a coverage of 100% of the described Medigap benefit. If there is no check mark and instead a percentage marker, Medigap policies on each plan cover up to that percentage for the according benefit provision. If a box is blank, the Medigap policy is not sufficient for that benefit. You should also note that Medigap plans from MedicareSupplementalInsurance.com providers only cover your coninsurance premiums if you have already paid the deductible.
Medigap Plans Effective June 1, 2012 |
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Medigap Benefits Chart |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F * |
Plan G |
Plan K |
Plan L |
Plan M |
Plan N | |
| Medicare Part A Coinsurance and Hospital Costs up to an Additional 365 Days After Medicare Benefits are Used Up. |  |
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| Medicare Part B Coinsurance or Copayment | |
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50% | 75% | |
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| Blood (First 3 Pints) | |
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50% | 75% | |
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| Part A Hospice Care Coinsurance or Copayment | |
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50% | 75% | |
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| Skilled Nursing Facility Care Coinsurance | |
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50% | 75% | |
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| Medicare Part A Deductible | |
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50% | 75% | 50% | |
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| Medicare Part B Deductible | |
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| Medicare Part B Excess Charges | |
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| Foreign Travel Emergency (Up to Plan Limits) | |
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| Out-of-Pocket Limit ** | |||||||||||
| $4,620 | $2,310 | ||||||||||
* Medigap Plan F also has a high deductible option available for your policy. Under the high deductible choice, it is your responsibility to cover the $2,070 for the 2012 period before your Medigap plan covers any additional cost.
** Medigap Plans K and G have additional out of pocket limits that will only require you pay $4,620 and $2,310, accordingly. Once that is covered by you (and you have also paid your yearly Part B deductible), the MedicareSupplementalinsurance.com provider Medigap plans will pay 100% of your covered services the rest of that calendar year.
*** Medigap Plan N will pay for 100% of your Part B consinsurance payment, up to a maximum of $20 for office visitations, as well as a $50 copayment for unexpected emergency room hospital visits that don't conclude in an longer duration stay at the hospital.
** Medigap Plans K and G have additional out of pocket limits that will only require you pay $4,620 and $2,310, accordingly. Once that is covered by you (and you have also paid your yearly Part B deductible), the MedicareSupplementalinsurance.com provider Medigap plans will pay 100% of your covered services the rest of that calendar year.* Medigap Plan F also has a high deductible option available for your policy. Under the high deductible choice, it is your responsibility to cover the $2,070 for the 2012 period before your Medigap plan covers any additional cost.
*** Medigap Plan N will pay for 100% of your Part B consinsurance payment, up to a maximum of $20 for office visitations, as well as a $50 copayment for unexpected emergency room hospital visits that don’t conclude in an longer duration stay at the hospital.
Each specific Medigap plan, no matter where you purchase it, offers the same coverage as that same specific plan sold by another company. Just as a jar of name-brand peanut butter sold in one supermarket is the same as one sold in a competing supermarket, each of the ten Medigap plans is the same regardless of who sells it to you. As with the peanut butter, the prices are different. In West Virginia, all but two insurance companies use the attained-age method of pricing. To compare rates, fill out the zip code form and find local plans now.
With the attained-age method, your premiums increase as you get older because the insurance company’s costs generally increase as people age. Your premiums are modest and relatively low in the early years, but you have no protection against increases. The other premium-rating methods give you that protection.
Federal law guarantees people age 65 or older the right to purchase a Medigap policy during the six-month period beginning in the first month you are covered under Medicare. Your premiums will be based on the standard premium-rating methods, which means you can’t be denied coverage or charged accordingly for pre-existing health problems. This period, called your open enrollment period, is the only time you will be able to sign up for or amend your Medigap policy. If you wish to make changes to your plan, you will have to wait until the national Open Enrollment period, which starts on October 15th and goes until December 7th. Any changes that you make to your plan will go into effect the following January 1st. If you want to make changes any time after these dates, you will be forced to wait until the next Open Enrollment. This means that if you don’t make changes quickly, you may have to wait up to one year to change.
If you’re under 65, the only Medigap policy you can buy in West Virginia is Plan B from United American Insurance Company. United American Insurance Company sells some plans that are attained-age-rated, but also sells others that are issue-age-rated. With issue-age-rated policies, your premiums will only increase due to inflation. All of the plans sold by AARP HealthCare Options (United Healthcare Insurance Company) are community-rated. Premiums paid by all plan subscribers are the same regardless of age. Fill out the zip code form now to find local plans and compare rates instantly.
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